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Top 10 Patient Safety Concerns for 2020

Each year, the nonprofit ECRI Institute puts out a “Top 10 Patient Safety Concern Executive Brief” aimed to bring a heightened awareness for a better continuum of care and stronger accountability for U.S. health care systems. The annual top 10 report ranks patient safety concerns in all health care settings and designed to help organizations identify dangerous patient safety challenges and offers suggestions and resources for addressing them.

The list for 2020 includes:

  1. Missed and Delayed Diagnoses

“Diagnostic errors that may have contributed to death have been found in 10% of autopsies.”

  1. Maternal Health Across the Continuum

“More than 700 women die each year from childbirth-related complications in the United States and about 60% of these deaths are preventable.”

  1. Early Recognition of Behavioral Health Needs

“Only 3% to 5% of violent acts are committed by an individual with a serious mental illness.”

  1. Responding To and Learning From Device Problems

“Patient harm from medical devices occurred in 84 of every 1,000 admissions in one hospital.”

  1. Device Cleaning, Disinfection, and Sterilization

“Sterile processing failures can lead to surgical site infections, which have a 3% mortality rate and an associated annual cost of $3.3 billion.”

  1. Standardizing Safety Across the System

“90 mergers and acquisitions were announced by healthcare organizations in 2018.”

  1. Patient Matching in the Electronic Health Record

“In the ECRI PSO Patient Identification Deep Dive, both of the two deaths identified in the sample related to EHR documentation failures.”

  1. Antimicrobial Stewardship

“In 2014, antibiotics were prescribed for antibiotic-inappropriate respiratory problems for 45.7% of patients who visited urgent care centers.”

  1. Overrides of Automated Dispensing Cabinets

“In one analysis of adverse medication event reports involving the use of overrides, 77% involved ADCs.”

  1. Fragmentation Across Care Settings

“Patients with several chronic conditions may visit up to 16 physicians in a year.”

Review ECRI’s full Executive Brief and medical statistical data used here.

Missed and Delayed Diagnosis at The Top Again

Some 12 million Americans each year are likely to experience a missed or delayed diagnosis in their primary care setting. According to the ECRI brief, “This year’s list called out missed or delayed diagnoses for their potential to impede timely, lifesaving care. In examining autopsies, ECRI found diagnostic errors may have contributed to death in one out of 10 cases studied.”

Doctors are held to a high standard of care because they have specialized education, training, and experience. The failure to make a diagnosis or an error in diagnosis may be considered negligence on the part of the doctor or medical staff. Sometimes a missed diagnosis does not do any harm to the patient. However, sometimes it can cause additional injuries or can make the condition worsen.

Coronavirus Will Lead Main Patient Safety Concerns in 2020

ECRI suggests the list “does not necessarily represent the issues that occur most frequently or are most severe,” and “is not meant to dictate which issues organizations should address.” So while the concerns were ranked before warning of the heightened coronavirus risks in the U.S., the spread of novel COVID-19 is also sure to be a top safety concern for patients across America’s hospitals. Common human coronaviruses usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. These illnesses usually only last for a short amount of time but can be severe in people with heightened health issues. Coronavirus is highly contagious and proven to spread easily. Centers for Disease Control and Prevention (CDC) actions for all persons such as:

  • Wash your hands often with soap and water for at least 20 seconds.
  • Avoid touching your eyes, nose, and mouth.
  • Avoid close contact with people who are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Stay home when you are sick. (Symptoms of COVID-19 include cough, fever, and shortness of breath.)
  • Clean and disinfect frequently touched objects and surfaces.

Hospital systems should be prepared to help infected patients prevent the spread of human coronaviruses through quarantine, avoiding personal contact, or touching an object or surface with the virus on it, and having staff and sick patients practice adequate hand washing.

The Continuum of Care and Risks for Patients in Long-Term Settings

As the continuum of care often concludes in a long-term care setting for patients who have become entirely dependent on a 24-hour care cycle, many of the issues listed in ECRI’s brief carry into this health care setting as well. And, this includes coronavirus. Infection control is a significant hurdle most U.S. long-term care facilities, including nursing homes and rehabilitation centers, just can’t get beyond. During this time of growing uncertainty:

  • Every long-term care facility should be holding infection control boot camps for their employees.
  • Limiting face-to-face contact between residents, staff, and visitors wherever possible.
  • Staffing policies must be overhauled to enable potentially ill employees to take time off while still achieving appropriate caregiver-to-patient ratios for adequate care.

Unfortunately, research tells us that long-term care facilities are often understaffed and have limited resources, contributing to a fail in setting up these basic infection controls even in the wake of a potential outbreak. Hospital staff may become burned out and infection control becomes unmanageable. Rightfully so, serious action is needed and federal and local governments, health care providers, hospitals, and the nursing home industry should be working together to protect staff and the people most vulnerable to an infectious disease outbreak across all care settings, throughout all phases in the continuum of care.

Free Consultation: Levin & Perconti Medical Malpractice Attorneys in Chicago

If you were a patient at an Illinois health system and suspect medical negligence may have contributed to further injury caused by the patient concerns included on this list or due to a failure in treating an infectious disease such as COVID-19, please call us toll-free at (877) 374-1417, or in Chicago at (312) 332-2872 for a FREE consultation.

Also read: Nursing Homes Already Have Infection Control Problems, Preventing Coronavirus Before It Spreads Will Be Another

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